Wilski Maciej, Tomczak Maciej
Department of Physical Culture of People with Disabilities, University School of Physical Education, ul. Królowej Jadwigi 27/39, 61-871, Poznan, Poland.
Department of Physiotherapy and Knowledge about Health, State University of Applied Sciences, Konin, Poland.
Ann Behav Med. 2017 Apr;51(2):179-188. doi: 10.1007/s12160-016-9841-5.
Discrepancies between physicians' assessment and patients' subjective representations of the disease severity may influence physician-patient communication and management of a chronic illness, such as multiple sclerosis (MS). For these reasons, it is important to recognize factors that distinguish patients who differently estimate the impact of MS.
The purpose of this study was to verify if the patients who overestimate or underestimate the impact of MS differ in their perception of personal resources from individuals presenting with a realistic appraisal of their physical condition.
A total of 172 women and 92 men diagnosed with MS completed Multiple Sclerosis Impact Scale, University of Washington Self Efficacy Scale, Rosenberg Self-Esteem Scale, Body Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale, and Socioeconomic resources scale. Physician's assessment of health status was determined with Expanded Disability Status Scale.
Linear regression analysis was conducted to identify the subsets of patients with various patterns of subjective health and Expanded Disability Status Scale (EDSS) scores. Patients overestimating the impact of their disease presented with significantly lower levels of self-esteem, self-efficacy in MS, and body esteem; furthermore, they perceived their condition more threatening than did realists and underestimators. They also assessed anti-MS treatment worse, had less socioeconomic resources, and received less support than underestimators. Additionally, underestimators presented with significantly better perception of their disease, self, and body than did realists.
Self-assessment of MS-related symptoms is associated with specific perception of personal resources in coping with the disease. These findings may facilitate communication with patients and point to new directions for future research on adaptation to MS.
医生对疾病严重程度的评估与患者对疾病严重程度的主观表述之间的差异，可能会影响医患沟通以及慢性病（如多发性硬化症，MS）的管理。基于这些原因，识别那些对MS影响有不同估计的患者所具有的区别因素非常重要。
本研究的目的是验证高估或低估MS影响的患者在对个人资源的认知上是否与对自身身体状况有现实评估的个体存在差异。
总共172名被诊断为MS的女性和92名男性完成了多发性硬化症影响量表、华盛顿大学自我效能量表、罗森伯格自尊量表、身体自尊量表、简短疾病认知问卷、治疗信念量表、实际获得支持量表和社会经济资源量表。医生使用扩展残疾状态量表来确定健康状况评估。
进行线性回归分析以识别具有不同主观健康模式和扩展残疾状态量表（EDSS）评分的患者子集。高估自身疾病影响的患者自尊水平、MS方面的自我效能和身体自尊水平显著较低；此外，他们比现实主义者和低估者更觉得自己的状况具有威胁性。他们对MS治疗的评估也更差，社会经济资源更少，并且比低估者获得的支持更少。此外，低估者对自身疾病、自我和身体的认知明显比现实主义者更好。
对MS相关症状的自我评估与应对疾病时对个人资源的特定认知相关。这些发现可能有助于与患者的沟通，并为未来关于适应MS的研究指明新方向。
